Abstract
BackgroundCommunity paramedicine programs have emerged throughout North America and beyond in response to demographic changes and health system reform. Our aim was to identify and analyse how community paramedics create and maintain new role boundaries and identities in terms of flexibility and permeability and through this develop and frame a coherent community paramedicine model of care that distinguish the model from other innovations in paramedic service delivery.MethodsUsing an observational ethnographic case study approach, we collected data through interviews, focus groups and field observations. We then applied a combination of thematic analysis techniques and boundary theory to develop a community paramedicine model of care.ResultsA model of care that distinguishes community paramedicine from other paramedic service innovations emerged that follows the mnemonic RESPIGHT: Response to emergencies; Engaging with communities; Situated practice; Primary health care; Integration with health, aged care and social services; Governance and leadership; Higher education; Treatment and transport options.ConclusionsCommunity engagement and situated practice distinguish community paramedicine models of care from other paramedicine and out-of-hospital health care models. Successful community paramedicine programs are integrated with health, aged care and social services and benefit from strong governance and paramedic leadership.
Highlights
Community paramedicine programs have emerged throughout North America and beyond in response to demographic changes and health system reform
We bring together the Australian RESP model [2] and new data from Canada to form a coherent framework (RESPIGHT) that describes the conceptual basis of a community paramamedicine (CP) model of care, distinguish it from other innovations in paramedic service delivery and provides guidance to providers contemplating its introduction
In the discussion and conclusion the RESPIGHT community paramedicine model of care emerges from the synthesis of previous studies and these data from Ontario
Summary
Community paramedicine programs have emerged throughout North America and beyond in response to demographic changes and health system reform. A small number of published studies have examined CP programs from a theoretical perspective [9], one of which utilised an observational ethnographic approach to develop a model built around the concepts of rural community engagement, emergency response, situated practice and primary healthcare. This is known as the RESP model [2]
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